More people are considering weight loss options. Here's what you should know about bariatric surgery

PHILADELPHIA (WPVI) -- A lot of people have gained a lot of weight during the pandemic, with one survey putting the average at 20 pounds.

That's fueled increased interest in weight loss surgery. If you are considering the procedure, you first should understand your options.

Bariatric surgeon Rohit Soans of Temple Health says too few people who could benefit from surgery are getting it.
"Only 1-percent of that population actually gets it," he said.

Dr. Soans and colleague Dr. Tatyan Clarke said a Body Mass Index, or BMI, of 40 or above qualifies for bariatric surgery.

So does a BMI between 35 and 40 for people with related conditions such as heart disease, diabetes, high blood pressure, or severe sleep apnea.

Dr. Clarke said procedures fall into two types, restrictive or metabolic.

Sleeve gastrectomy, in which surgeons remove 80 to 85% of the stomach works mostly by restriction.

"It's literally like the sleeve of a jacket," said Dr. Clarke. "Decreasing the volume and compliance of the stomach, meaning how much food you can get into the stomach."

Dr. Soans said gastric bypass changes the metabolism.
"We re-route the intestines and create a limb that is a malabsorptive limb. So when patients eat, they can't absorb as many of the calories from that limb," he said.

Both operations have low complication rates.

"We have been able to make bariatric surgery safer than gallbladder surgery," said Dr. Soans. "They go home the next day, within a week, they're pretty much functional."

Bypass patients may lose a little more weight over a longer time, and the pounds may stay off better. But it may be easier to manage nutrition after the sleeve, which changes vitamin and mineral absorption less.

But both require extensive screening and preparation before surgery, and changes in eating and exercise afterward.

"The first thing that you need to ask yourself is how ready you are for the change. While a person may be ready to lose weight, they may not necessarily be ready to make the changes necessary," said Dr. Clarke.

Having a strong support team, your surgeon, psychologists, and dietitians, is essential for success. Drs. Soans and Clarke hope more people will consider bariatric surgery, because COVID is especially dangerous for the obese.
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